fertilisation failure

Hi there,
I just found out that of 17 eggs collected, not one fertilised, but my husband's semen analysis was normal. We're told that it's difficult to say whether it's egg/sperm or both. Last cycle, we had a low fertilisation rate too (only 4 out of 13), and of the 4 embryos, 3 stopped developing.
To me, this is looking like an egg quality issue. I also have an endometrioma on one ovary. Prior to these 2 IVFs, we've had 2.5 years of TTC, including 3 IUIs with injectables. Never ever been pregnant. I'm 33. So's my husband.
Every single outcome we've had with AC has been worse than the last. And we never see it coming. We're certainly not crazy optimists either (as you can tell from my login name). Of course, ICSI is the next step (I have no idea why it wasn't recommended this time).
We're seeing our FS today. Any tips on what to ask? Any ideas about what could be wrong, and if we have much hope now.

ICSI would seem the next logical step, as there may be an issue with either the sperms' ability to penetrate the egg, or the egg having a tough zona (shell). I have certainly read about this type of issue before, so try not to despair, which of course is easier said than done right now.

Good luck.

Sorry I don't have any advice but just wanted to lend some support. My approach is that I expect my FS to be the expert and have always asked what he thought I should do next. I did ask my FS why I wasn't doing PGD or ICSI given how long we had been TTCing and he said (as did the nurses at my clinic) that they like to interfer as little as possible as this gives the best outcomes unless proven otherwise (e.g. by doing a couple of cycles or where they is an already identified issue). I am sure your FS will give you a plan of attack (and if you aren't happy with it don't leave until you are!) and I hope it isn't long for you to get that long awaited BFP cycle :)

So sorry that you are not getting any good news from your FS.

To me a zero fertilisation rate could be a number of things. It could be that there is a sperm issue that isn't turning up on the semen analysis (which only looks at the "look" of the sperm), it could be that your eggs aren't as mature as they think they are, or it could possibly be a genetic issue of some sort.

DH and I both had a DNA profile done (I think it cost about $700) which given what cycles now cost may be worth it. Or ICSI could be wourth a go, but if the sperm appear normal then I'm not sure how this would help (it is usually used when there are low sperm numbers or where the sperm doesn't have the energy to break the shell of the egg)

There is also something about some women carrying antibodies to sperm - but I'm sorry - I don't know much about it at all.

Good luck.

Hey thank you everyone for your really helpful replies!

I saw our FS who seems pretty sure it's egg maturity, rather than an "innate" egg issue. He's suggested a different stim protocol, this time with lower stims (fewer eggs, maybe better quality?). There's so much variation each time, it feels so ... like experimental cookery, or something, rather than hard science - this time, we'll try tortillas with smashed sweet potato!

It's so complex, too. Our friend is an embryologist at another IVF clinic, and she's also in our ear, like "Hey, what lab protocols do they use? When did they check the eggs? Perhaps they were over- or under-mature?" etc. Then I'm thinking, perhaps we'll have to change clinics? Argh! It's so confusing and overwhelming at times. I've kind of stopped sleeping and just have a permanent loop of IVF-related thoughts in my head. So boring.

Muppity, thanks for the info about the DNA test - that sounds interesting.

Anyway, I'll actually try to work now, I guess.

Best of luck to everyone,
WW

we have to have ICSI as my DH spermies are trapped due to a VAS, so no other choice but they do say as little interference the better, good luck to you and maybe a move is in order.

Worrywart, on our first cycle DW was super stimmed for want of a better term, and although she had more eggs than a battery hen farm, a lot wouldn't fertilise due to immaturity.

Hi Worrywart, sending you a big hug and I know how hard it is when a cycle is ended due to no eggs fertilising and no definite reason why, but please don't give up hope.

My DH (50) and I (39) went through this on our 2nd and 3rd stimulated cycles (the 3rd cycle was ICSI) and the specialists could not give us a reason why no eggs had fertilised (we had "unexplained infertility"). I was not totally happy with with the IVF clinic's attitude or response (they suggested IVF probably was not going to work for me) and after much thought decided to change clinics, had a bit of a break, saw a naturopath to help me get healthier, and went to a GP for acupuncture to try to help me relax and improve my next cycle. The new clinic decided to try a short cycle and this improved my fertilisation rate (not sure why the other clinic did not try this after my first cycle with no fertilisation). On the 2nd cycle with the new clinic I only ended up with 1 strong embryo and 1 okay embryo, had them both transferred and was shocked to get my first BFP after 4 years of TTC.

I wish you all the very best.

Kazza02

Thanks so much Kazza02 - it's heartening to read your own story. It does give me some hope. Congratulations too on your DD!
I guess I'm not ready to throw in the towel just yet and I'll consider moving clinics, depending on how things go with the next round. Taking a break now, trying TCM/acupuncture and treating my back problem (possibly unrelated but still a pain), and getting a lap this month to check out endo.
It was just such a shock, even though I thought I'd been measured enough in my expectations, esp after the first go, which had quite a poor outcome - I just didn't expect things to get worse, rather than better.
Nothing can prepare you for IVF, right? It's the strangest thing I've experienced, putting it mildly.
Thanks again, best of luck,
WW

Thanks Worrywart. I think a break is a good idea, well I felt it helped me get myself together and make myself stronger both physically and mentally for the next cycle after the two cancelled cycles. I also had a lap done whilst having a break for my own peace of mind. I also tried TCM in conjunction with acupuncture and I like to think maybe the combination of TCM/acupuncture, the naturopath, the break and the new protocol the IVF clinic tried all played a part in helping to improve the outcome.

Take care of yourself and I wish you all the very best for a BFP.

Kazza02 :)